Knee Pain Caused by Kneecap Conditions
The kneecap, or patella, serves as a bony shield for this vulnerable part of the leg. Designed to take extensive wear and tear, the kneecap is essential for maintaining flexibility as you age. An injury or disease affecting the kneecap can also cause problems with ligaments, cartilage, muscles, and meniscus.
Common conditions surrounding the kneecap include:
- Meniscus tears
- Broken kneecap
- Dislocated kneecap
- Damaged cartilage
- Bursitis (prepatellar)
- Tendonitis (jumper’s knee)
- Patellar tracking disorder
- Patellofemoral pain syndrome (runner’s knee)
Patellar fractures can occur in a variety of ways, both in contact sports, car accidents and falls. Any part of the kneecap can cracked, broken or shattered into several pieces. The break can be stable (in alignment) or displaced (separated and pushed out of place). Open kneecap fractures result in the broken bone breaking the skin, leading to complications and more difficulty healing.
Bursitis in the kneecap develops when the fluid-filled sacs become irritated and swollen. Inflamed bursa cause pressure to build inside the knee joint, causing pain in the nearby ligaments, muscles and tendons. Kneecap bursitis may start with an injury, an infection, or after a long period of overuse. This painful knee condition tends to be an occupational hazard for those working in a kneeling position such as plumbers, carpet installers, roofers, gardeners, and janitorial workers.
Another painful knee condition is a torn meniscus. Frequently, sports injury causes damage to the cartilage inside the kneecap. The cartilage acts as stabilizing, shock absorbing material between the bones above and below the knee. The meniscus tear can occur in several configurations: bucket handle, flap, radial, and degenerative.
Jumper’s knee, or patellar tendonitis, develops when the tendon stretching between the kneecap and lower leg (tibia) tears. Everyone needs the combined strength of the patellar tendon, quadriceps muscles, and quadriceps tendon to straighten their knee. A severely torn kneecap tendon can even dislodge part of the bone, causing more painful damage. Causes of patellar tendonitis include falls, jumping injury, steroid use, tendinitis inflammation, and chronic diseases such as rheumatoid arthritis, diabetes, or systemic lupus erythematosus.
Chronic knee pain from runner’s knee or jumper’s knee may be diagnosed as patellofemoral pain syndrome. This kneecap disorder can affect both athletes and nonathletes with pain, stiffness and impaired mobility. Patellofemoral pain syndrome radiates pain through the soft tissues of the kneecap. In some cases, cartilage under the kneecap breaks down, causing chondromalacia patella or inflammation of the tissue that lines the knee joint.
The painful kneecap condition of patellar tracking disorder refers to the kneecap shifting out of place as the knee moves. Damaged cartilage or strained connective tissue may allow the kneecap to pop off track. Patellar tracking disorder may be related to patellofemoral pain syndrome, misaligned leg bones, or weakness in quadriceps muscles and tendons.
Find Treatments for Kneecap Conditions
Kneecap injuries and patellar disorders can often be treated with proven orthopedic techniques including anti-inflammatory medication, casts, orthotic shoe inserts, splints, reduced activity, pain management, and physical therapy.
More invasive kneecap procedures to alleviate pain and correct problems can range from needle aspiration to remove excess bursa fluid to arthroscopic knee surgery, or minimally invasive knee replacement surgery.
Meniscus tears are often treated with arthroscopic kneecap surgery (arthroscopic chondroplasty) to trim or repair the damaged cartilage inside the knee joint. Torn cartilage can be stitched back together, depending on the severity of the damage.
If the damaged cartilage is completely removed, a physically fit patient with an active lifestyle may benefit from meniscus transplant to replace the missing meniscus with donor cartilage. Autologous chondrocyte transplantation takes healthy cartilage from your knee and grows them in a lab.
In other cases of cartilage loss, minimally invasive orthopedic surgery called articular cartilage restoration is used. Microfracture drilling on the kneecap helps stimulate growth of scar tissue composed of healthy cartilage.
Older patients may opt for a total knee replacement or partial knee replacement. In these cases, all or part of the interior of the kneecap are “resurfaced” with metal and plastic implants cemented directly into the bones of t he tibia or femur.
Patellar pain syndrome or kneecap tracking disorders may be treated with minimally invasive arthroscopic knee surgery to remove damaged cartilage or perform a lateral tendon release.
In other cases, an orthopedic knee surgeon may recommend tibial tubercle transfer to realign the kneecap. This procedure involves moving the patellar tendon and part of the bony knob at the top of the shin bone. Tibial tub ercle transfer requires an open surgical approach so that the repositioned bone can be screwed into place.
Torn patella tendons often require orthopedic surgery along with physical therapy to repair the damaged kneecap tendon. Knee surgeons may reattach the tendon to the kneecap with the latest in metal implants (suture anchors) or the more traditional drill holes in the kneecap. If the patellar tendon has been shortened by repeated injury, a tendon graft may be recommended.
Broken kneecaps may be repaired using pins, wires or screws. The surgical hardware may be removed a year or more after surgery, once the bone has healed. If the kneecap is shattered in several pieces, small parts of the bone may be removed in addition t o securing the rest of the kneecap with screws or wires.
Consult an Orthopedic Knee Specialist
When knee pain related to kneecap conditions threatens your ability to move freely, it’s time to turn to an orthopedic specialist for help. Patients can find orthopedic knee surgeons, sports medicine doctors, and physical therapists at Baylor Orthopedic and Spine Hospital at Arlington. Call 855-41-ORTHO to set up an appointment to have your kneecap condition evaluated, diagnosed, and treated with expert care.